Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 1-17-25084 | CA |
NPI | 1093217283 |
---|---|
Provider Name | Ms. Olivia Michelle Aragon |
First Address | San Ramon, CA 94582-4536 |
Second Address | Danville, CA 94526-4025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2018 |
Last Update Date | 02/03/2018 |